title: A pathway-based analysis of urinary arsenic metabolites and skin lesions.
abstract: Inorganic arsenic is metabolized to monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). Limited evidence suggests that the ability to fully metabolize arsenic into DMA influences susceptibility to disease. To determine whether percentage of MMA was predictive of disease, the authors used data from a case-control study conducted in Bangladesh (2001-2003). Persons who were diagnosed with keratosis, melanosis, Bowen's disease, or squamous cell carcinoma were matched on age, sex, and village to persons without these conditions. This analysis was restricted to persons who had no missing data on covariates (859 cases, 868 controls). A path analysis was used to evaluate simultaneously the association between the percentage of all urinary arsenic metabolites and the odds of skin lesions using PROC CALIS in SAS, version 9.1 (SAS Institute, Inc., Cary, North Carolina) and Mplus, version 6.1 (Muthén & Muthén, Los Angeles, California). The odds of skin lesions were significantly associated with log(10) percentage of MMA (adjusted odds ratio (OR(adj)) = 1.56, 95% confidence interval (CI): 1.15, 2.12) but not log(10) percentage of inorganic arsenic (OR(adj) = 1.06, 95% CI: 0.75, 1.50) or log(10) percentage of DMA (OR(adj) = 1.07, 95% CI: 0.33, 3.46). This novel analysis confirmed that persons who excrete a higher proportion of MMA have a greater risk of skin lesions after data are adequately controlled for urinary arsenic metabolites, current arsenic exposure, and other risk factors.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA. mkile@hsph.harvard.edu
authors.forename: Molly L
authors.initials: ML
authors.lastname: Kile
authors.forename: Elaine
authors.initials: E
authors.lastname: Hoffman
authors.forename: Ema G
authors.initials: EG
authors.lastname: Rodrigues
authors.forename: Carrie V
authors.initials: CV
authors.lastname: Breton
authors.forename: Quazi
authors.initials: Q
authors.lastname: Quamruzzaman
authors.forename: Mahmuder
authors.initials: M
authors.lastname: Rahman
authors.forename: Golam
authors.initials: G
authors.lastname: Mahiuddin
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Hsueh
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000328:Adult; D020261:Arsenic Poisoning / Q000378:metabolism*; D001152:Arsenicals / Q000652:urine*; D001459:Bangladesh / Q000453:epidemiology; D002101:Cacodylic Acid / Q000652:urine*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012871:Skin Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D014874:Water Pollutants, Chemical / Q000009:adverse effects; D014877:Water Pollution, Chemical / Q000009:adverse effects
chemical_list: D001152:Arsenicals; D014874:Water Pollutants, Chemical; D002101:Cacodylic Acid; C020300:monomethylarsonic acid